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Tbilisi State Medical Universit

                 

 

 

 



                                           With handwrite  permission 

 

     


 

 

 



Tea Zerekidze 

 

 



 

Characteristic Features of Cephalometric 

Parameters in Patients with 

class III Malocclusion

 

               14.00.21._Stomatoligy 



 

     


                     AAbstract of dissertation  

(autorefferate) 

 

To  seek a scientific degree of a Medical Doctor (MD) 

 

 



 

 

 



Tbilisi 

2006 


 

 

Research work was performed at Tbilisi State Medical University; Moscow Medical 



Stomatological University and Georgian-German-Spanish Dental and  Medical Clinic “UniDent-

RŐS’S” 


 

 

 



 

 

 



 

Scientific Tutor of research                               - Zurab Vadachkoria, M.D, Ph.D 



                                                                            Doctor of Medical Sciences

                                                                            Professor. 

 

Official Opponents    -                                       - Vladimer MargvelaShvili, M.D,Ph 



                                                                             Doctor of Medical Sciences, 

                                                                             Professor.(14.0021). 

                                                               

                                                                            -Samson Mgebrishvili, M.D, Ph.D 

                                                                              Doctor of Medical Sciences, 

                                                                              Professor.(14.0021). 

 

 

 



 

The defense of the Dissertation will be held _____________2006, at ___________  

At Tbilisi State Medical University, at Scientific Council Meeting 14.21 No: 2  (0177, Tbilisi, 

33, Vazha-Pshavela Avenue) 

 

 

Dissertation is available at the library of Tbilisi State Medical University (0160, Tbilisi, 29, 



Vazha-Pshavela Avenue) 

 

 



Abstract of dissertation had been sent out ____   ________________ 2006 

 

 



Academic Secretary of dissertation’s  council 

Doctor of Medical Sciences,   

 

                                                 



Professor                                                                                                                   M. Iverieli 

 

 



 

 

 



Introduction 

 

Problem Actuality. Medial occlusion is a quite complicated anomaly of anterior occlusion of 

the jaw-teeth system. Among occlusion anomalies the share of medial occlusion is 4-6% (O. 

Darjania, 2005; Jacobson A, 1980; Kalamkarov Kh. A. et al., 1981; Manetti V., 1984; Miller J. 

P., 1990; Latyi A. A., 1998; Hunter W. S., Snigler P., Mamandras A. H. 1997; Bacetti T. 1999; 

Persin L. S., 1999). Though, A. M. Kovalevskaya et al., 2001 report that according to data for 

2001, in recent times, frequency of this anomaly, among both, boys and girls, grew almost as 

twice. 

Medial occlusion is on of the most complicated anomalies of the jaw and teeth system. It is 



characterized with disorders of growth and development of alveo-dental arcs, facial part of the 

scull and basal structures of the scull. This occlusion anomaly is characterized with 

morphological, functional and esthetic disorders of the jaw and teeth system, what has negative 

impact on the psychical condition of the patients. With respect of the above, in modern 

orthodontia there is a trend of improvement of diagnostic and treatment methods, directed 

towards optimization of treatment results (T. Kublashvili, 2006; Person L. S., Kuznetsova G. V., 

Popova I. V., 1999; Khoroshilkina F. Ya., 1999; West K. S.,m McNamara J. A., 1999; Andrey 

Centner, 2001). 

Occlusion curve is a curve of interfacing of the upper and lower teeth and therefore, regular 

position of the teeth and direction of occlusion curve is one of the conditions of development of 

physiological occlusion. All this is of great importance for face esthetics. T. Mikadze, 1999; 

Lulla P, Gianelli A, 1976; Rakosi T, Schilli W 1981; Segner D. 1989; Gieva Yu. A. et al., 18998; 

popova I. V., 1998; Bednyakov A. A., 2001; Persin L. S. et al., 2002 describe relations of  

formation of the occlusion curve with various anomalies of jaw and teeth system. In the literature 

there is very poor information about influence of various growth type of the scull on teeth 

location in patients with medial occlusion. Impact of the type of jaw growth on occlusion curve 

in patients with medial occlusion is not studied adequately up to date. The issue of diagnostics in 

contemporary orthodontia is quite acute. 

Teleroentgenography is of special significance for diagnostics of anomalies of the jaw and teeth 

system. Through studying of the linear and angular parameters of teleroentgenography it is 

possible to predetermine the sizes and locations of separate tooth, teeth arcs and apical bases, 

also harmony of the structure of facial part of the scull. Most cephalometric methods allow for 

studying of arcs of the upper and lower jaws. The problem of elaboration of the one single 

criterion, which would be common for the teeth arcs of both, upper and lower jaws, is a 

significant problem. In the process of development of the jaw and teeth system there is formed 

the occlusion curve, direction of which is greatly influenced by type of growth of the bones of 

upper and lower jaws. Types of growth of jaw bones were first described by Bjork A., Skiller V 

(1977). 

It is also necessary to study characteristic features of location of the incisors, canines and molars, 

with regard of type of growth of the jaws and age in patients with medial occlusion; Changes of 

the occlusion curve direction, in patients with medial occlusion, taking into consideration age of 

the patients and jaws growth type; Parameters of location of the occlusion curve, correlation of 

ordinate point K and gonial angles, for various growth types of the jaws. 

 

 


Purpose of the research. improvement of diagnostics of medial occlusion anomalies, taking 

into consideration the type of scull growth and treatment orthodontic tactics. 



Objectives

 



Cephalometric analysis of cephalograms of the patients with physiological occlusion (in 

the periods of changing and permanent occlusion); 

 

Studying of linear and angular parameters of cranofacial and cranocerebral parts in 



patients with medial occlusion (in the period of changing and permanent occlusion) and 

comparizon of the obtained parameters with the physiological occlusion; 

 

Cephalometric analysis of impact of the jaws growth type on formation of the occlusion 



plane; 

 



Studying of the impact of jaws growth type and direction of the occlusion plane on 

standing of teeth; 

 

Determination of correlation dependence between cephalometric parameters in patients 



with medial occlusion, for all three types of growth of the jaw bones. 

 

Scientific novelty of the work

For the first time: 

 



There were determined characteristic features of locations of the incisors, canines and 

molars in the patients with class III malocclusion, regarding various types of growth of 

the scull and age of the patients; 

 



There was assessed characteristics of location of the occlusion plane in the patients with 

class III malocclusion, taking into consideration various types of growth of the scull and 

age; 



 



There was studied correlative dependence between the parameters determining location 

of the occlusion plane – Ordinate K and gonal angles in patients with class III 

malocclusion, for various types of scull growth. 

 

Practical value of the work

 

Results obtained in the process of research facilitate effective diagnostics of class III 



malocclusion and improvement of treatment ways; 

 



These was justified application of vertical elastic supports for vertical type of jaw growth; 

 



There was justified treatment of back dissocclusion of the incisors for vertical-type 

growth of jaw bones through inclination of the incisors and canines in patients with class 

III malocclusion; 


 

In planning of orthodontic treatment of the patients with class III malocclusion it is 



recommended to study the values of K-Po parameters. 

 

Basic theses to be reported at the defense 

 

For the patients with class III malocclusion there is characteristic medial inclination of 



the coronas of upper incisors, canines and molars of the upper jaw and distal inclination 

of the coronas of upper incisors, canines and molars of the lower jaw. Degree of 

inclination depends on the growth type of the jaw bones. Inclination of the upper teeth is 

more prominent for horizontal and neutral type of growth of the jaw bones and 

inclination of the lower teeth – in case of vertical type of growth. 

 



In case of horizontal and neutral types of jaws growth change of inclination of the upper 

incisors may be followed with by change of alveodental vertical heights in the frontal 

part, and in case of vertical growth similar signs were not noticed. 

 



Among all parameters of direction of jaws growth, gonal angle and its components have 

the greatest impact on location of the teeth, their inclination and alveodental heights and 

therefore on location of occlusion plane. 

 



Inclination of the occlusion plane depends on the type of growth of the jaw bones: in case 

of vertical type growth, clockwise rotation of occlusion plane takes place and ion case of 

horizontal type of growth – rotation is anticlockwise. 

Practical Use of Stady Results 

Results of our research work are in curriculum for lecture courses and practical training of 

students at Tbilisi State Medical University- Department of Pediatric and Preventional of Dental 

Diseases,also in practical use  at Georgian-German-Spanish Dental and  Medical Aesthetic 

Clinic “UniDent-RÖS’S”. 

 

Approbation: Materials of the dissertation are reported and discussed at the Enlarges Session of 

Tbilisi State Medical University Departments of Stomatological Profile and Association of 

Stomatologists of Georgia (Tbilisi, 26

th

 March, 2006). 



 

Publications: We have published 4 scientific works on the issues of dissertation. 

 

Structure and volume of the dissertation: Dissertation is represented on 138 pages and 

includes following chapters: Introduction; Literature Review; Research Object; Materials and 

Methods; Obtained Results; Consideration of Obtained Results; Conclusions; Practical 

Recommendations. The work is illustrated with 15 tables, and 73 Pictures. List of references 

includes 166 sources. 



 

   Object of the Research, Materials and Methods 

Materials were obtained in 1999-2005, at the Department of Child Stomatology and Prevention 

of Stomatological Diseases on Tbilisi State Medical University; at the Department of Children 

Prosthodontics and Orthodontia of Moscow State Medical Stomatological University and 

Georgian-German-Spanish Clinic of Dentistry and Medical Esthetics, “Unident-Ross”. 

The work is based on study of 60 patients of age from 7 to 25 and 30 persons with physiological 

occlusion. The patients were divided into three groups: first group included 16 patients, with 

vertical growth of the jaw bones; in second group there were 18 patients with horizontal-type 

growth of jaw bones and in 26 patients from the third group there was indicated neutral type 

growth of jaw bones. The patients were divided into two age groups: from 7 to 12 and from 12 to 

25; among these patients 23 had the period of changing of the teeth and 37 – period of permanent 

occlusion. 

To provide uniform group of the patients we did not include patients with cross and open bites 

and those, who experienced extraction of the teeth and surgery on the lower jaw bone. We 

studied the patients clinically and with X-rays. 

 

On each cephalogram we studied 18 linear (Fig. 1) and 



27 angular (Fig. 2) parameters. We applied Schwartz; 

Bjork; Di Paolo (Fig. 3) cephalometry methods and K-

analysis. 

       Fig. 1. Linear parameters  

of the cephalogram 

  


       

Fig. 2. Angular parameters                                         

Fig. 3. Di Paolo quadrilateral analysis 

    


of the cephalogram 

 

For each studied parameter there were determined simple average, quadratic mean deviation; 



there was determined error of simple average, relation between the studied parameters was 

determined through correlation ratio; in case of reliable correlation we calculated the coefficient 

of determination, where R – is correlation coefficient. Weak – R = 0.1 - 0.3; Medium – R = 0.4 – 

0.6; Strong – R = 0.7 - 1.0 

 

Obtained results and their discussion

 On the basis of studying of the upper and lower incisors of the patients with medial occlusion, 

comparing with the generally recognized anatomic indicators (reference lines) (Fig. 4) and via 

analysis of the obtained results, we concluded that in patients with medial occlusion there is 

statistically reliable (p < 0.001) distal inclination of the lower incisor coronas towards the plane 

of the lower jaw, what points to retrusive inclination of lower incisors. Statistical processing of 

the angles of upper incisors showed their protrusive location, statistically reliable growth of  

Fig. 4. Location of incisors towards the 

                                                                                                      upper and lower jaw bases 


0

20

40

60

80

100

120

Period of teeth change

Period of permanent occlusion

 

 



 

Fig. 5 Location of upper and lower incisors 

in the periods of deciduous and permanent occlusion 

                                 

          

We have analyzed locations of upper and lower incisors in the period of teeth 

changing and period of permanent occlusion (Fig. 5) in the patients with medial occlusion. On 

this basis we made a conclusion that protrusion of upper incisors and retrusion of lower incisors 

grow with age. 

We have compared and analyzed the parameters of location of the canines in patients with 

physiological and medial occlusions (Fig. 6). 

 

 



 

150

 

100

 

50

 

0

 

 



<<

K K


K-L3

K  


K-U3




     


  

Class III malocclusion       

Physiological occlusion

 

 



Fig. 6. Inclination of upper and lower canines against reference lines 

   


Coronas of the upper canines have medial inclination, what is confirmed by statistically 

reliable (p < 0.001) decrease of inclination of the upper canine to the scull basis and the basis of 

upper jaw bone < 3NS; Statistical (p < 0.001) increase of Vsp to < 3NL (p < 0.05) and vestibular 

plane < 3. This, on its side caused increase of distance from the K point to the convexity of upper 

canine (p < 0.001), lower canines are distally inclined, what is confirmed by increase of 

inclination of lower canine to the basis of lower jaw and vestibular plane (p < 0.001). 

As 38% of the patients with medial occlusion had no canines in the dentition, we had chance to 

study direction of cutting out of the canines, to determine, whether medial inclination of the 

upper canines and distal inclination of the lower canines could be regarded as pre-determined, 

genetically (Fig. 7). 

 

  Inclination of the upper canines to the plane of jaw basis is greater by 4.0+1.94˚ in those 



people, whose canines were at the stage of cutting out. These changes are statistically reliable (p 

< 0.05) and shows that inclination of canines is changed at a time of cutting out. It turned out that 

inclination of the corona, at a cutting out stage is within normal range. 



On the basis of analysis of the obtained results we can conclude that for the patients with medial 

occlusion, medial inclination of upper canine coronas and before cutting out (in the period of 

being within the body of upper jaw) the germs of the canines have normal inclination and the 

coronas of the lower canines are characterized with distal inclination towards the plane of lower 

jaw basis. 

 

 



 

 

 



 

 

0



20

40

60

80

100

120











 

 



 

 

 



 

 

 



 

 

 



 

 

 permanent occlusion



    deciduous occlusion

 

 



Fig. 7 Location of the upper canines in the periods deciduous and permanent occlusion 

    


 

First permanent molars play leading role at the initial phase of formation of permanent occlusion. 

They ensure vertical growth of alveolar process, growth of jaw bones in the distal sections, 

dynamics of formation of dentition formation, complete chewing function, correct articulation, 

symmetric development of the face. 

In patients with medial occlusion the angle of inclination of longitudinal axis of the first 

permanent molar to the plane of the frontal part of the cranial basis is reduced (p < 0.01) and to 

the plane of the basis of the same jaw (p < 0.05), what conforms medial inclination of the 

coronas of the first permanent molars of the maxilla. Yet, distance from K point to the first molar 

of the maxilla is less than normal value (p < 0.01), what points to distal location of entire upper 

dentition and perhaps retro location of the upper jaw, in patients with medial occlusion. 

As for the first lower molars, their location, location K point and their inclination to the plane of 

the jaw basis and vestibular plane, all these are within norm (Fig. 8) 

 


 

 

 



 

 

 



 

 

 



  

 

 



 

 

0



20

40

60

80

120

100





K - L6







K-U6

K-L6

 

 



 

                               Medial occlusion   

    Physiological occlusion  

Fig. 8. Comparison of location of the first molars in patients with class III malocclusion and 

normal location. 

 

We have also studied location of the third molars against the plane of cranial basis and planes of 



bases of upper and lower jaws (Fig. 9). Characteristic parameter of location against cranial basis 

plane of maxilla third molar is actually one and the same for physiological and medial 

occlusions. The change is not reliable statistically (p > 0.05). Angles of inclination of the 

longitudinal axes of the third molars of upper and lower jaws to the planes of the bases of 

respective jaws are practically identical in people with medial and physiological occlusion and 

existing differences are not statistically reliable (P > 0.05). 

 



 

 

 



 

 

 



 

 

 



 

 

 



0

20

40

60

80

100

120







Physiological occlusion

Medial occlusion

 

Fig. 9  Comparison of the location third molars of the patients with medial occlusion with normal 



locations. 

Occlusion plane is the plane of curve of coming together of two dentitions. Direction of the 

occlusion plane determines the function of jaws and teeth at a great extent and is of great 


significance for the face esthetics. We studied inclination of occlusion plane to the planes of jaw 

bases and vestibular plane and conducted quadrilateral analysis by Di paolo technique 

In the patients with medial occlusion, in the teeth change period, angle of inclination of 

occlusion plane with the maxilla plane is reduced by 3.03+1.2 (p < 0.01). Angles between the 

occlusion plane and mandibula basis plane and vestibular plane are within normal values. In the 

studied patients, angle of inclination of the occlusion plane, increase in average by 2.98+0.07, 

with age (Fig (10).           

 

 



 

 

 



 

 

 



 

          permanent occlusion 

         deciduous   occlusion                                                  

 

0



5

10

15

20

25

30









Fig. 10. Formation of the occlusion curve in patients with class III malocclusion. 

 

 

We can make conclusion that in patients with medial occlusion front alveldental height is 



decreased and back alveodental height is increased (occlusion plane turns anticlockwise). On the 

basis of analysis of the obtained data, that in the process of growth and development of 

craniofacial osseous system, in patients with medial occlusion, occlusion plane rotates 

anticlockwise, on account of decrease of the teeth alveolar heights in the area of lower molars.   

We grouped data on the studied patients with medial occlusion by the types of growth of jaw 

bones and compared the results with normal values. We divided patients into three groups: in the 

first group there were 30 patients, with vertical type growth of the jaw bones (Bjork 

summarizing angle > 396º). The second group included 36 patients with horizontal type growth 

of the jaw bones (Bjork=381

°). The third group involved those 84 patients, who were 

characterized with natural type growth of jaw bones (Bjork summarized angle =396º ± 3.0). 

Patients with horizontal and neutral types of growth the location of upper incisors. their 

inclination angle to the plane of maxilla base is lower, what points to their protrusion. In case of 

vertical type growth on the jaw bones location of the upper incisors of patients with medial 

occlusion is close to normal location. As for lower incisors, in case of vertical growth type, their 

retrusion takes place (p < 0.01). In case of horizontal and neutral growth type retrusion of lower 

incisors takes place, but these data were not reliable (p > 0.05) (Fig. 11) 

 

 

 



 

 

 



                                                  

                                              

 

 

 



 

 

 



 

 

0



20

40

60

80

100

120



  



v



Norm

Vertical growth type of the jaws 

 Neutral growth type of the jaws

   Horizontal growth type of the 

jaws

 

Fig. 11. Comparative characteristic of incisors for various types of growth of the jaw bones in 



patients with class III malocclusion.  

 

 



In case of vertical type growth in the patients with medial occlusion there was noticed trend of 

distal inclination of the upper canine coronas (p > 0.05). Distal inclination of the lower canines 

was statistically unreliable (p > 0.05) (Fig. 12). 

 


 

                                                  

 

 

 



 

 

 



 

 

 



 

 

 



 

 

0



20

40

60

80

100

120











L3/M





Norm

Vertical growth 

type of  the jaws

Neutral growth 

type of the jaws

Horizontal growth type of 

the jaws

 

Fig. 12.  Comparative characteristic of canines’ location in patients with class III malocclusion. 



for various growth types of jaws and norm. 

 

Minor decrease of the angle between the lower molar axes and vestibular plane was indicated in 



those patients, which were characterized with vertical type of growth of the jaw bones (p < 

0.001). In the above patients first permanent upper molars were inclined medially (p < 0.05), 

unlike those patients, who are characterized with vertical and neutral type growth of jaw bones 

(Fig. 13) 

 

 

 



                                                                              

 

 



                                          

 

 



 

 

 



0

10

20

30

40

50

60

70

80









Norm

Vertical growth type of 

the jaws 

Horizontal growth type of the  jaws

Neutral growth type of the  jaws

Fig. 13.  Comparative characteristic of location of the first molars in patients with class III 

malocclusion. for various growth types and norm. 

 

In the process of researches there was determined that angle of inclination of the occlusion plane 



to the plane of the lower jaw basis grew in those patients, which were characterized with neutral 

and vertical type of growth of the jaw bones (p < 0.01), and alveolar height of the teeth, in 

patients of this group, in the area of the first molar of lower jaw did not change (there was 


indicated clockwise rotation of the occlusion plane), what was confirmed by increase of the 

angle of inclination of the plane of lower jaw towards vestibular plane (Fig. 14). 

 

 

 



 

 

 



 

 

 



 

 

 



 

0

5

10

15

20

25

30





<

Ocp/NL





Norm

Vertical growth type of the jaws

Horizontal growth type of the jaws

Neutral growth type   of the jaws

Fig. 14. Comparative characteristic of occlusion 

locationfor various growth types of the jaw bones and 

norm, in patients with class III malocclusion.

Inclination of occlusion plane depends on the type of growth of the jaw bones at a more or less 

extent: In case of vertical type growth rotation of the occlusion plane is clockwise and in case of 

horizontal and neutral type of growth rotation is anticlockwise (Fig. 15) 

 

 

 





Horizontal and neutral 

growth types of the  jaws

 

 



Vertical growth type of the 

jaws 

 

Fig. 15. Rotation of the occlusion plane 



 

We have assessed and analysed parameters from cephalograms of the patients with class III 

malocclusion, with jaw bones growing in different directions. 

Studied showed that alveodental heights of the upper and lower jaws have numerous correlation 

dependencies in the area of the first molars. Similar dependencies were indicated in the areas of 

upper and lower incisors and upper and lower canines. In the latter case there was indicated very 

string direct dependence (Fig. 16) 

                                                               

                                                        Direct dependence   

 

                                                        Negative dependence 



                                           Fig. 16. Correlative dependencies of  

                                                   alviodental heights in the areas    

                                                        of the molars      

             

  

 Among all the parameters characterizing teeth locations, their inclinations, alveodental heights 



and therefore, occlusion plane, gonial angle and its components have the greatest impact. Above 

is confirmed by direct correlative dependence of the average force with lower gonial angle, for 

vertical and horizontal type of growth of the jaws and absence of such dependence in case of 

neutral type of growth. 

In case of vertical type of growth of the jaw bones increase of lower gonial angle is followed by 

protrusion of upper incisors r=0.6, and in case of neutral or horizontal types of growth there is 

observed minor negative dependence (Fig. 17). 

 

                                                          Direct dependence 



                                                                                     

                                                  

Negative dependence

        


kavSiri                             

 

 



   

 Fig. 17. Correlative dependences of lower angle

 

 

 



Location of level of K point on the occlusion plane (K-Po) is related to the size of lower gonial 

angle and impacts location of the first upper molar as in sagital, also in vertical direction (U



6

-

NL). (r= 0,7). (Fig. 19). 



L

L

6

6

 

 





 

 

M

M

L

L

 

 

 

 

N

N

G

G

o

o

A

A

r

r

 

 

 

 

 

 

U

U

3

3

 

 





 

 

N

N

L

L

 

 

 

 

U

U

6

6

 

 





 

 

N

N

L

L

 

 

 

 

N

N

G

G

o

o

G

G

n

n

 

 

 

 

r



=



0

0

,

,

8

8  

r

r

 

 

=

=

 

 

0

0

,

,

6

6

 

 

 

 

r

r

 

 

=

=

 

 

0

0

,

,

6

6

 

  

r

r

 

 

=

=

 

 

0

0

,

,

5

5

 

 

 

 

r

r

 

 

=

=

 

 

0

0

,

,

7

7  

r

r

 

 

=

=

 

 

-

-

0

0

,

,

6

6

 

 

 

 

 

 

 

 

r

r

 

 

=

=

 

 

0

0

,

,

7

7

 

 

 

 

 

 

<

<

N

N

G

G

o

o

G

G

n

n

 

 

 

 

<

<

U

U

1

1

/

/

N

N

L

L

 

 

<

<

N

N

L

L

/

/

O

O

c

c

p

p

 

 

r

r

 

 

=

=

 

 

-

-

0

0

,

,

5

5

 

 

r

r

 

 

=

=

 

 

-

-

0

0

,

,

5

5

 

 

L

L

3

3

 

 

-

-

 

 

M

M

L

L

 

 

 

 

                                                          Direct dependence 



 

 

                                                           Negative dependence 



 

 

 



 

 

 



Fig. 18 Correlative dependencies of lower gonial angle and K-Po 

 

                           Conclusions 



1.

 

Characteristic features of class III malocclusion include medial inclination of the coronas 



of upper incisors, canines and molars and distal inclination of coronas lower incisors, 

canines and molars. Degree of inclination depends on the type of growth of the jaw bones.  

Inclination of the upper teeth is more prominent in case of horizontal and neutral types of 

growth of the jaw bones, whereas inclination of the lower teeth – in case of vertical type 

of growth (p < 0.01). 

2.

 



In patients with class III malocclusion upper canines have normal inclination towards jaw 

basis, before cutting out, but at a time of cutting out and taking their place in the dentition 

they obtain medial inclination (p < 0.05). 

3.

 



Occlusion plane, in patients with class III malocclusion changes its dislocation with age, 

on account of reduction of lower alveodental heights and increase of back alveodental 

heights, or there occurs its rotation anticlockwise (p<0,01). 

4.

 



Inclination of the occlusion plane strongly depends on the type of growth of the jaw 

bones: in case of vertical type of growth there occurs rotation of the occlusion plane 

clockwise (p < 0.01), whereas in case of horizontal type of growth rotation is 

anticlockwise. 

5.

 

In case of horizontal and neutral growth types of the jaw bones the change of inclination 



of the upper incisors might be followed by change of alveodental heights in the front part 

(r-0.7) and in case of vertical type of growth this is not observe (r= -0.6). 



 

 

<

<

O

O

c

c

p

p

/

/

M

M

L

L

 

 

 

 

N

N

G

G

o

o

G

G

n

n

 

 

K

K

 

 





 

 

P

P

o

o

 

 

 

 

<

<

O

O

c

c

p

p

/

/

N

N

L

L

 

 

 

 

K

K

 

 





 

 

U

U

6

6

 

 

U

U

6

6

 

 





 

 

P

P

t

t

v

v

 

 

 

 

U

U

6

6

 

 

-

-

 

 

N

N

L

L

 

 

r

r

 

 

=

=

 

 

-

-

0

0

,

,

4



r

r

 

 

=

=

 

 

0

0

,

,

7

7

 

 

r



=



-

-

0

0

,

,

7



r

r

 

 

=

=

 

 

0

0

,

,

5

5

 

 

r



=



-

-

0

0

,

,

4



r



=



0

0

,

,

6



r

r

 

 

=

=

 

 

0

0

,

,

4

4

 

 

6.

 

The gonial angle and its components have the greatest impact on location of the teeth, 



their inclination and alveodental heights and therefore on the location of the occlusion 

plane, among all parameters, characterizing direction of growth of the jaw bones. (r=0.6). 

7.

 

Level of location of “K” point on the occlusion plane (K-Po) is interrelated with the size 



of lower gonial angle and impacts location of the first upper molar as in sagital (K-U

6

), 



also in vertical directions (U

6

-NL). (r= 0,7). 



8.

 

There were observed strong correlative dependencies between the alveodental heights in 



the areas of incisors and first molars on upper and lower jaws, in patients with medial 

occlusion (r =0,8). 

9.

 

In patients with class III malocclusion of the dentitions there exists correlative 



dependence between K-Po parameter, characterizing level of location of the K point and 

angle of inclination of the occlusion plane to the planes of jaw bases and there are 

observed positive  relations – to the upper jaw r=0.6, negative – with the lower jaw r= - 

0.5. 


10.

 

Parameter K-Po characterizing location of the occlusion plane against otopharyngeal 



opening is comparable with the parameter, characterizing the distance from distal survace 

if the first molars to the phtherigo-maxillar fissure. Power of correlative dependence 

depends of the type of growth of jaw bones. This dependence is stronger (r=0.7), in case 

of neutral type of growth of the jaw bones and weaker – in case of vertical (r=0.5) and 

horizontal (r=0.4) types of growth. 

 

 



Practical Recommendations 

1.

 



For orthodontic treatment of the patients with class III malocclusion, in case of vertical type 

of growth of the jaw bones, it is not likely that change of inclination of the upper incisors 

would cause change of alveodental height in the frontal segment, therefore, to ensure the 

contact, it is recommended to apply additional vertical supports.  

2.

 

In case of vertical type growth of the jaw bones, inclinations of upper and lower incisors 



and canines are close to normal value; compared with the respective inclinations in case of 

horizontal and neutral types of growth. Consequently, against the background of vertical 

type growth, in patients with class III malocclusion   we can close (or reduce) back sagital 

gap via change of inclination of incisors and canines, within allowed deviation (+ 5

). 


3.

 

In planning of orthodontic treatment of patients with class III malocclusion of the dentitions 



it is recommended to study the value of K-Po parameter, as it characterizes level of location 

of the occlusion plane against numerous reference points and in the process of orthodontic 



treatment, through change of this parameter (K-Po) we could propose clockwise rotation of 

the occlusion plane (at a time of extrusion of molars), or anticlockwise (in case of intrusion 

of the molars). 

4.

 



In case of horizontal type of growth of the jaw bones, when there is indicated tight standing 

of the teeth of medium severity (3-6 mm), it is possible to incline frontal teeth without 

extraction, in a vestibular way, whereas in case of vertical growth of the jaws, extraction is 

necessary.  

 

List of Works Published on the Issue of Dissertation 

 

1.



 

Intrusion Arc R. Nanda // Fourth International Dental Congress ( Proceedings ) 4-6 

September, Yerevan 2003 ., p. 96-98.  

2.

 



Characteristic Features of the Canines in Patients with class III malocclusion .  

       Collection of Scientific Works, vol. XL,Tbilisi State Medical University 2004, 

      pp. 196- 198 (Co-author Z. Vadachkoria)                                             

3.

 



Characteristics of Formation of the Occlusion Plane in Patients with class III 

malocclusion, Depending on Age. 

//Georgian Medical News, # 12(129), 2005, стр. 37-40. 

4.

 



Specific features of location of the anterior teeth in patients with class III malocclusion. 

   //Annals of Biomedical, Research and Education, 2006, vol. 5 , Issue 4 ,  

       p. 216-218,      (Coauthor Z. Vadachkoria). 

 

 



Document Outline

  • Introduction
  • Object of the Research, Materials and Methods
  • Conclusions
  • Practical Recommendations
  • List of Works Published on the Issue of Dissertation


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